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Medicine: Organizational Problems

Healthcare organizations face various problems that affect the quality of care. In my workplace, two problems appear to be crucial for patient outcomes and the success of our organization. First, there is a significant shortage of nurses in or our hospital. According to Haddad and Toney-Butler (2019), the shortage is expected to grow in the nearest future, as by 2026 there will be additional 1.1 million nurses needed to satisfy the needs of the US healthcare system. Second, our organization experiences problems with reimbursement due to an increased number of denies from Medicare and Medicaid. Among other reasons, this problem is caused by a growing number of hospital-acquired infections (HAIs). According to Kaier et al. (2020), HAIs are associated with 10-15 percent of additional treatment costs, which are not reimbursed by the insurers. Addressing any of the two problems listed above will result in improved quality of care and increased cost-efficiency.

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Reflection on Personal Experience

Nurse shortage affects the work process of all stakeholders, including patients, their families, doctors, healthcare managers, and nurses. As nurses, my colleagues and I often need to work extended hours to cover for missing nurses. Increased workload contributes to stress and burnout, which, in turn, create turnover intentions. Thus, the problem of nurse shortage is associated with increased turnover, which further aggravates the shortage of nurses. New nurses need time to adapt to the policies of our organization, which makes their productivity low. Thus, the hospital is forced to spend additional funds to deal with turnover and eliminate nurse understaffing.

As for reimbursement problems, I had limited experience dealing with the consequences of the problem. However, managers and senior staff often emphasize the importance of HAI prevention practices, such as hand washing and the thoughtful use of antibiotics. In general, our hospital is transforming the workplace culture to focus on the safety of patients. When caring for patients, I encountered cases of death and significant morbidity from HAIs. I also noticed that patients with HAIs tend to spend more days as inpatients, and the cost of their stay increases significantly in comparison with patients without such complications. Considering my experience, I prefer to work on the problem of a nurse shortage, as I feel more competent discussing issues in which I have first-hand experience.

Systems Thinking Assessment

If I can address the problem of a nurse shortage, it will affect the organization on several levels. First, it will improve the satisfaction of nurses will increase workplace satisfaction of front-line employees (Haddad & Toney-Butler, 2019). Second, it will decrease the number of missed treatments, which will significantly improve the quality of care (Metcalf, Wang, & Habermann, 2018). Improved quality of care and satisfied personnel will inevitably cause increased customer satisfaction. However, the problem will require a revolutionary approach to improve nurse staffing, such as attracting more males to the profession. Currently, less than 10% of nurses are males due to biases associated with the profession (Cottingham et al., 2017).

When speaking of reimbursement problems associated with HAIs, I will need to assess adherence to the current hand hygiene policies. Improved adherence to hygiene standards is expected to decrease the number of HAI cases, which will reduce the costs that cannot be reimbursed (Kaier et al., 2020). Additionally, patient satisfaction is expected to increase, as there will be fewer complaints about extended hospital stays, increased morbidity, and high costs.


Cottingham, M., Dill, J., Choroszewicz, M., & Adams, T. L. (2017). Intergenerational dynamics among women and men in nursing. Journal of Nurse Education 56(5), 295-299.

Haddad, L., & Toney-Butler, T. (2019). Nursing shortage. NCBI. Web.

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Kaier, K., Wolkewitz, M., Hehn, P., Mutters, N. T., & Heister, T. (2020). The impact of hospital-acquired infections on the patient-level reimbursement-cost relationship in a DRG-based hospital payment system. International Journal of Health Economics and Management, 20(1), 1-11.

Metcalf, A., Wang, Y., & Habermann, M. (2018). Hospital unit understaffing and missed treatments: Primary evidence. Management Decision, 56(10), 2273-2286.

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